MONTE SCHOLARSHIP APPLICATION 2018

Graduates/Alumni

BACKGROUND INFORMATION:

NAME:
LAST NAME / FIRST NAME / MIDDLE INITIAL
SEX: / ¨ Male / ¨ Female / DATE OF BIRTH: ______/______/______
Month Day Year
PRIMARY MAILING ADDRESS:
NUMBER / STREET / APARTMENT
CITY / STATE / ZIP CODE / TELEPHONE #
EMAIL ADDRESS:

ARE YOU A U.S. CITIZEN? ¨ Yes ¨ No

If no, do you have a student visa?

/ ¨ Yes ¨ No
If yes, what type of student visa do you have?

(Please check one category. Note: Your response is optional.)

¨ AFRICAN AMERICAN / ¨ AMERICAN INDIAN / ¨ ASIAN
¨ CAUCASIAN / ¨ HISPANIC / ¨ OTHER:______
MOTHER’S (or Legal Guardian’s) NAME: / ¨ Living ¨ Deceased
HOME ADDRESS (if different from yours):
EMAIL ADDRESS:
OCCUPATION:
FATHER’S (or Legal Guardian’s) NAME: / ¨ Living ¨ Deceased
HOME ADDRESS (if different from yours):
EMAIL ADDRESS:
OCCUPATION:


APPLICANT INFORMATION:

YEAR OF ASD GRADUATION:
COLLEGE NOW ATTENDING:
NAME / STATE
Number of years attended: / Expected date of graduation: / ______/______/20______
Major Course of Study:
Cumulative GPA _____
College(s) Previously Attended
NAME / STATE
NAME / STATE

*Please attach your latest available college transcript with this application.

SCHOOL AND COMMUNITY ACTIVITIES (including athletics, extracurricular, and volunteer activities):

Type of Activity / Positions Held / Years Participating

WORK EXPERIENCE (including summer and part-time jobs held):

Employer and Address (indicate supervisor and phone number) / Type of Job / Dates

Recommendations: Please list three people and attach three letters of recommendation:

1. / Name: / Relationship:
Address:
City, State, Zip:
2. / Name: / Relationship:
Address:
City, State, Zip:
3. / Name: / Relationship:
Address:
City, State, Zip:

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ESSAY: 100 words, minimum

What are your goals for the future? How will college help you accomplish these goals?

If an adult assisted you in writing the essay or completing the application, please include their name(s). ______

The undersigned hereby certifies that the information provided on this application, including attachments, is true to the best of my knowledge.

Student Applicant: / Date:

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CHECKLIST

Did you complete each part of the application? / ¨ Yes / ¨ No
Did you attach a college transcript? / ¨ Yes / ¨ No
Did you include all (3) three written letters of recommendation? / ¨ Yes / ¨ No

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2017-2018